Types of Ambulatory Surgery and Other Outpatient Services Collected by the Partner

The Indiana Hospital Association (IHA) collects a broad range of outpatient data including ambulatory surgery, emergency department visits, cardiac diagnostic treatment, observation services, occupational therapy (including occupational physical and occupational health), outpatient newborn delivery, and psychiatric chemical dependency.

IHA does not collect data for records classified as being pathology or labs only.

Through September 30, 2015, IHA defined an ambulatory surgery record as having an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) principal procedure code in the range of 00.30-86.99.

A new definition of an ambulatory surgery record as of October 1, 2015 with the transition to ICD-10-CM/PCS is not available.

Beginning in 2022, IHA adopted new surgery flag definitions which increased the number of surgeries being categorized.

Outpatient Data File Provided to HCUP by the Partner

IHA provides HCUP with a data file specific to ambulatory surgery and selects these records from their broader outpatient data set.

Selection of Records for Inclusion in the SASD

All records identified by IHA as ambulatory surgery (included in the separate AS file) are included in the SASD.

Additionally, any records in the SASD that also have evidence of emergency department services based on the HCUP criteria (HCUP data element HCUP_ED > 0), are also included in the HCUP State Emergency Department Databases (SEDD). These records will have the same value for the HCUP data element KEY.

Types of Facilities Included in the Files Provided to HCUP by the Partner

IHA collects ambulatory surgery and other outpatient services data from hospital-owned facilities. IHA does not collect data from ambulatory surgery facilities that are not owned by a hospital.

Identification of Hospital-Owned Ambulatory Surgery and Other Types of Outpatient Facilities in the SASD

The designation of a facility as hospital-owned is specific to its financial relationship with a hospital that provides inpatient care and not related to its physical location. Hospital-owned ambulatory surgery and other outpatient care facilities may be contained within the hospital, physically attached to the hospital, or located in a different geographic area. The designation as hospital-owned means that HCUP can identify that the hospital is billing for this service.

Starting in data year 2018, the HCUP data element HOSPITAL_OWNED can be used to identify hospital-owned facilities with ambulatory surgery and possibly other outpatient care data in the SASD. A facility is considered hospital-owned (HOSPITAL_OWNED = 1) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (HOSPITAL_OWNED = 0). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with HOSPITAL_OWNED=0 are hospital-owned.

From data year 1998-2018, the HCUP data element was called FREESTANDING. A facility is considered hospital-owned (FREESTANDING = 0) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (FREESTANDING = 1). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with FREESTANDING=1 are hospital-owned.

Exclusion of Records During HCUP Data Processing

Beginning with 2016 data, records with a discharge disposition of "still a patient" are retained in the HCUP SASD. Prior to 2016 data, these records were excluded.

Beginning in 2010, records with a designation of "admitted as an inpatient" are retained in the SASD, even though this rarely occurs. Prior to 2010, records with a designation of "admitted as an inpatient" were excluded from the files.